Holding on with hope

Spring City Pharmacy in Colfax is facing an uncertain future. The community staple is looking to local state legislators to pass legislation that will greatly benefit not only Spring City Pharmacy but all other pharmacies across Iowa.

“Our biggest struggle is that a large portion of the prescriptions we (or any pharmacy) fill, the pharmacy benefit managers (PBMs) pay us less than it costs us to buy the drugs,” Spring City Pharmacy owner Brad Magg said. “So it’s not uncommon to lose anywhere from $1-$200 filling a patient’s prescription before we even pay for overhead like lights, staff, labels and packaging.”

In just the three years Magg and fellow owners Brittney Van Howeling and Brenda Tjaden have been in charge of the pharmacy, they have lost $105,884.57 just filling 9,790 prescriptions. Magg points to PBMs as middlemen or subcontractors that have minimal regulations or oversight managing the prescription drug portion of health insurance for insurance companies.

“For instance, Canada does not have PBMs, and their wholesale drug prices are 30 percent less on average than America’s,” Magg said. “Think of how much different healthcare would be if 30 percent of all of the prescription drug sales in America were split between pharmacies so they could be paid for the work they do, health insurance companies to reduce premiums and out-of-pocket prices for patients lowered.”

Two bills are moving through the statehouse: Senate File 383 and House File 852. According to Magg, the legislation would require PBM’s and insurance companies to pay pharmacies what the drug actually costs and bans them from charging the insurance companies more for the prescription than they pay the pharmacy.

“Basically making them be transparent about the fees that they’re collecting instead of skimming their profits from what is intended to go to the pharmacies,” Magg said. “In its current form, the legislation also requires them to pay a small dispensing fee to help cover the overhead costs, as well.”

Iowa House Rep. Jon Dunwell recently addressed the issue saying HF 852 is on the House unfinished business calendar, ensuring it is “funnel-proof” and will remain under consideration for this session. It has already passed the commerce committee unanimously.

“Throughout my tenure, we’ve consistently tackled issues surrounding PBMs, yet progress has been stalled repeatedly by the Senate,” Dunwell said.

The owners are asking community members to contact any and all state senators and ask them to support SF 282. He singled out three specific senators as most critical to the cause: Kike Klimesh, Ken Rozenboom and Amy Sinclair. “It’s expected to pass the Iowa House, but just like last year, despite having enough votes for it to pass, we’re afraid the senate will refuse to even bring it to a vote,” Magg said. “From what we understand, reaching out to these three senators is the most crucial.”

Should it stall again this year, Spring City Pharmacy is looking at a very different future. From no pharmacist on site to having to completely close, the locally run business will be looking at hard times.

“There could be a possibility of someone taking it over as a telepharmacy, but that means there would no longer be a pharmacist on-site, and everything would be done via video conference,” Magg said. “Telepharmacies typically have reduced hours, such as being open only half of the day instead of all day.

“Honestly, though, that would be a best-case situation. Most likely, we would be forced to close, and there would no longer be a pharmacy in Colfax. No matter how badly we want to try and hang on for just six more months or even a year, we’ve run out of things that we can borrow against, and we have no cash left to pay the suppliers or the employees since we fill so many prescriptions at a loss.”

He also pointed out the lack of patronage from community members. While it is comforting knowing a pharmacy is available in Colfax, it hasn’t necessarily lead to locals using the services.

“It is disappointing some days to see the lack of patronage from community members,” Magg said. “We’ve had local customers talk about how they forgot to get something at Wal-Mart, and they’ll be happy we have the exact product they wanted. Some even mention that it’s slightly cheaper than what they got it for last time at the big box stores because we are trying hard to be affordable and competitive for the community. Only to never see that person in the store until a year later when they forgot something else.”

Since 1906, there has been a pharmacy on the corner of North Walnut and Howard Streets in downtown Colfax. For the first 110 years, the Weirick and Patterson families had a well-run business that weathered both World Wars, recessions and everything in between. Magg, Van Howeling and Tjaden wanted to keep the business going and put a lot into making sure it wouldn’t disappear to history.

“We are also the only locally owned pharmacy in all of Jasper County, and I like to think the level of care we provide as members of the community, versus owners and executives who can’t even find Jasper County on a map, is exceptionally different,” Magg said. “When we opened Spring City Pharmacy, we assumed the most significant service we would be helping were those who don’t have a vehicle or can’t afford to drive out of town. However, I quickly realized the people who depend on us the most are the loved ones pushing the limit for still living independently. Without us, they might not be able to live on their own anymore, forcing them to leave the community.”

Along with the pharmacy, the business boasts a robust selection of over-the-counter medical items, a large selection of greeting cards, toys, home decor and gift items. They were able to save the historic soda fountain and are proud to serve classics including Vanilla Cokes and green rivers along with homemade ice cream.

“Those of us who grew up here remember it from our childhood,” Magg said. “When the three of us, all lifelong residents born and raised in Colfax, came together to reopen and save our only pharmacy, we knew it wouldn’t be easy and that we would be lucky to break even, but we were okay with that as long as we could pay our bills. Never did we imagine that it would be legal, let alone common, to be forced to fill so many prescriptions at a loss.

“Forty pharmacies closed last year in Iowa alone. Nationwide, one independent and two chain pharmacies close every day. If this legislation doesn’t pass, or if something doesn’t happen very soon, there will be no pharmacies left. Imagine being sick and needing an antibiotic, but you have to wait for it to come in the mail three days after your doctor sends in the prescription. That is what it will be like in the next few years if something doesn’t happen.”